Aljuaid Abdulaziz S, Badirah Sara B, Abusaeed Rowaina I, Almalki Abdulrahman M, Almaghrabi Murouj A, Alzahrani Emad A, Alhazmi Khalid A, Almaghrabi Ammar A, AlQarni Abdullmoin M, Alghamdi Khalid M
College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.
Department of Preventive Medicine, Ministry of Health, Makkah, Saudi Arabia.
J Spine Surg. 2024 Jun 21;10(2):264-273. doi: 10.21037/jss-23-104. Epub 2024 May 8.
Brucellosis is a zoonotic disease that is widely spread across the globe, with the number of cases increasing annually. Spinal brucellosis is known to affect about half of patients with brucellosis. Nevertheless, data on the optimal antibiotic regimens for spinal brucellosis are limited. Therefore, this study aims to compare antibiotic treatment regimens for spinal brucellosis at our center in Makkah, Saudi Arabia.
This is a retrospective cohort study of an 11-year period from 2010 to 2021 conducted at a single center in Makkah, Saudi Arabia. All patients with spinal brucellosis were included. Patients were excluded if the duration of the received antibiotic regimen or follow-up was poorly documented. Data analysis was conducted using RStudio (R version 4.1.1). Categorical variables of each regimen used by the patients were presented as frequencies and percentages, while numerical variables were summarized using the median and interquartile range (IQR).
A total of 35 patients were included; the median (IQR) age of the patients was 58.0 (48.0 to 63.0) years. The most frequently reported symptoms upon admission included low back pain (83.3%). The most frequently administered regimen was the combination of streptomycin + doxycycline + rifampicin (SDR) (20 patients, 55.6%), followed by the combination of streptomycin + rifampicin + trimethoprim/sulfamethoxazole (SRT) (eight patients, 22.2%). Overall, out of the total 35 patients who received first-line treatment, only six patients experienced therapy failure. Out of the total six patients who experienced first-line treatment failure with SDR (five patients, 83%) and SDT (one patient, 17%), surgery was indicated for three patients. Surgical intervention was deemed necessary in 12 patients (34%). Three patients chose not to undergo surgical intervention but still showed complete improvement upon completing the treatment duration. One patient experienced a postoperative complication, resulting in paraplegia.
In this study, we found that among 35 patients, treatment failure was observed only in six patients who received triple therapy. In addition, surgical intervention was indicated in 12 patients; however, three patients refused surgery and improved ultimately after changing or extending the duration of the antibiotic regimen.
布鲁氏菌病是一种人畜共患病，在全球广泛传播，病例数逐年增加。已知脊柱布鲁氏菌病约影响一半的布鲁氏菌病患者。然而，关于脊柱布鲁氏菌病最佳抗生素治疗方案的数据有限。因此，本研究旨在比较沙特阿拉伯麦加我们中心治疗脊柱布鲁氏菌病的抗生素治疗方案。
这是一项在沙特阿拉伯麦加的一个中心进行的回顾性队列研究，研究时间为2010年至2021年的11年期间。纳入所有脊柱布鲁氏菌病患者。如果所接受的抗生素治疗方案持续时间或随访情况记录不佳，则排除患者。使用RStudio（R版本4.1.1）进行数据分析。患者使用的每种治疗方案的分类变量以频率和百分比表示，而数值变量则使用中位数和四分位间距（IQR）进行总结。
共纳入35例患者；患者的中位（IQR）年龄为58.0（48.0至63.0）岁。入院时最常报告的症状包括腰痛（83.3%）。最常使用的治疗方案是链霉素+强力霉素+利福平（SDR）联合用药（20例患者，55.6%），其次是链霉素+利福平+甲氧苄啶/磺胺甲恶唑（SRT）联合用药（8例患者，22.2%）。总体而言，在接受一线治疗的35例患者中，只有6例患者治疗失败。在因SDR（5例患者，83%）和SDT（1例患者，17%）导致一线治疗失败的6例患者中，有3例患者需要手术治疗。12例患者（34%）被认为需要手术干预。3例患者选择不接受手术干预，但在完成治疗疗程后仍显示完全康复。1例患者出现术后并发症，导致截瘫。
在本研究中，我们发现，在35例患者中，仅6例接受三联疗法的患者出现治疗失败。此外，12例患者需要手术干预；然而，3例患者拒绝手术，在更改或延长抗生素治疗疗程后最终康复。
